Treatments for nasopharyngeal cancer

Nasopharyngeal cancer starts in the nasopharynx, which is the upper part of the pharynx.

If you have nasopharyngeal cancer, your healthcare team will suggest treatments based on your needs and work with you to develop a treatment plan. The plan is based on your health and specific information about the cancer. What you want or prefer is also important when planning treatment. When deciding which treatments to offer for nasopharyngeal cancer, your healthcare team will consider:

• the stage
• possible side effects
• your age
• your overall health
• any medical problems you may have
• your lifestyle
• if you have had other treatments
• if you would be a good candidate for a clinical trial

Radiation therapy using intensity-modulated radiation therapy (IMRT) is the standard treatment for stages 0 and 1 nasopharyngeal cancer.

Find out more about radiation therapy for pharyngeal cancer.

Radiation therapy may be offered as the first treatment for stage 2 nasopharyngeal cancer.

Chemoradiation may be offered instead of radiation therapy, and it may be followed by chemotherapy alone.

Surgery may be used to remove the lymph nodes in the neck.

Find out more about chemotherapy for pharyngeal cancer, radiation therapy for pharyngeal cancer and surgery for pharyngeal cancer.

Chemoradiation is the standard treatment for stage 3 nasopharyngeal cancer. Chemotherapy alone may be used before chemoradiation is started, and it may be continued by itself after chemoradiation therapy is finished.

Surgery may be used to remove lymph nodes in the neck.

Find out more about chemotherapy for pharyngeal cancer, radiation therapy for pharyngeal cancer and surgery for pharyngeal cancer.

At stages 4A and 4B, the cancer hasn’t spread to other parts of the body (metastasized). The standard treatment at these stages is chemoradiation. Chemotherapy by itself may be given before the start of chemoradiation, and more chemotherapy may be given after chemoradiation is finished.

Radiation therapy alone may be offered instead of chemoradiation.

Stage 4C nasopharyngeal cancer means the cancer has spread to other parts of the body. Chemotherapy with cisplatin and other drugs is the main treatment. If the cancer responds to treatment, radiation therapy or chemoradiation therapy may be given after chemotherapy has finished.

Immunotherapy with the drugs toripalimab (Loqtorzi) or tislelizumab (Tevimbra), in combination with cisplatin and gemcitabine, may be offered for stage 4C nasopharyngeal cancer. These immunotherapy drugs may also be offered by themselves after chemotherapy has finished.

Find out more about radiation therapy for pharyngeal cancer, chemotherapy for pharyngeal cancer, surgery for pharyngeal cancer and immunotherapy for pharyngeal cancer.

Recurrent nasopharyngeal cancer means that the cancer has come back after it has been treated.

Immunotherapy with toripalimab (Loqtorzi) or tislelizumab (Tevimbra), in combination with cisplatin and gemcitabine, may be offered for recurrent nasopharyngeal cancer. These drugs may be offered by themselves after chemotherapy has finished.

Surgery may also be offered to remove a local recurrence of the tumour.

If youʼve had radiation therapy to treat nasopharyngeal cancer before it recurred, your healthcare team may offer additional focused radiation therapy if it’s safe to do so, based on the amount of radiation youʼve already been given.

Chemotherapy with cisplatin and gemcitabine may be offered as the first treatment for recurrent nasopharyngeal cancer. If you have already been given cisplatin, drugs such as paclitaxel or docetaxel may be used.

Find out more about immunotherapy for pharyngeal cancer, radiation therapy for pharyngeal cancer and chemotherapy for pharyngeal cancer.

Talk to your doctor about clinical trials open to people with nasopharyngeal cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.

You may want to consider a type of care to make you feel better without treating the cancer itself. This could be because the cancer treatments donʼt work anymore, theyʼre not likely to improve your condition or they may cause side effects that are hard to cope with. There may also be other reasons why you canʼt have or donʼt want cancer treatment.

Talk to your healthcare team. They can help you choose care and treatment for advanced cancer.